title: Lifetime congenital isolated GH deficiency does not protect from the development of diabetes.
abstract: OBJECTIVE
  Adult subjects with untreated, lifetime, isolated GH deficiency (IGHD) due to a homozygous GHRH receptor gene mutation (MUT/MUT) residing in Itabaianinha, Brazil, present with lower BMI, higher prevalence of impaired glucose tolerance (IGT), increased insulin sensitivity (IS), and reduced β-cell function (βCF) when compared with non-BMI-matched homozygous normal controls. However, the prevalence of diabetes mellitus (DM) in this cohort is unknown. Comparing their IS and βCF with BMI-matched individuals heterozygous for the same mutation (MUT/N) may be useful to elucidate the role of the GH-IGF1 axis in IS and βCF. The purposes of this work were to verify the prevalence of IGT and DM in adult MUT/MUT subjects from this kindred and to compare IS and βCF in MUT/MUT and MUT/N.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  We studied most (51) of the living IGHD adults of this kindred who are GH naive. The oral glucose tolerance test (OGTT) could be performed in 34 subjects, fasting glucose was measured in 15, while two had a previous diagnosis of DM. The OGTT results of 24 MUT/MUT subjects were compared with those of 25 BMI-matched MUT/N subjects. IS was assessed by homeostatic model assessment of insulin resistance (HOMA-IR), quantitative IS check index, and oral glucose IS index for 2 and 3 h. βCF was assayed by HOMA-β, insulinogenic index, and the area under the curve of insulin:glucose ratio.
  
  
  RESULTS
  The prevalence of DM and IGT in IGHD was 15.68 and 38.23% respectively. IS was increased and βCF was reduced in MUT/MUT in comparison with MUT/N.
  
  
  CONCLUSIONS
  Lifetime, untreated IGHD increases IS, impairs βCF, and does not provide protection from diabetes.
authors.affiliation: Division of Endocrinology Federal University of Sergipe Aracaju, Sergipe, 49060-100 Brazil.
authors.forename: Taísa A R
authors.initials: TA
authors.lastname: Vicente
authors.forename: Ivina E S
authors.initials: IE
authors.lastname: Rocha
authors.forename: Roberto
authors.initials: R
authors.lastname: Salvatori
authors.forename: Carla R P
authors.initials: CR
authors.lastname: Oliveira
authors.forename: Rossana M C
authors.initials: RM
authors.lastname: Pereira
authors.forename: Anita H O
authors.initials: AH
authors.lastname: Souza
authors.forename: Viviane C
authors.initials: VC
authors.lastname: Campos
authors.forename: Elenilde G
authors.initials: EG
authors.lastname: Santos
authors.forename: Rachel D C Araújo
authors.initials: RD
authors.lastname: Diniz
authors.forename: Eugênia H O
authors.initials: EH
authors.lastname: Valença
authors.forename: Carlos C
authors.initials: CC
authors.lastname: Epitácio-Pereira
authors.forename: Mario C P
authors.initials: MC
authors.lastname: Oliveira
authors.forename: Andrea
authors.initials: A
authors.lastname: Mari
authors.forename: Manuel H
authors.initials: MH
authors.lastname: Aguiar-Oliveira
keywords: GH deficiency; diabetes; insulin sensitivity; β-cell function